WITH the pandemic in full swing, getting access to regular medications from hospitals has become a challenge for many, as people prefer to avoid these places.
Getting medications by post, commonly provided by hospitals in Malaysia, helps counter this problem to some extent.
Hospitals under the Ministry of Health have the UMP programme or "Ubat Melalui Pos", a collaborative programme with Poslaju to deliver medications by mail.
However, the transportation of temperature-sensitive products has always been a logistical challenge.
Most hospitals are unable to deliver some medications, especially cold-chain medications, due to special logistics requirements to maintain a certain temperature during pick-up, delivery and storage.
Out of every 10 patients on regular medication, three are unable to receive their medications by post because the existing service providers are unable to fulfil the delivery of cold-chain medications.
Universiti Malaya Medical Centre (UMMC) has taken steps to address this issue.
A STEP FURTHER
Cold-chain medications are those that need to be maintained at a specific temperature range, usually between 2° and 8° Celsius, explains UMMC director Dr Nazirah Hasnan.
"Storage-wise, these medications need to be kept in the fridge. Interruptions of the cold supply chain will cause damage to these drugs and affect their shelf life, safety and efficacy."
UMMC Pharmacy usually requires patients to bring a cold bag with ice in order to collect cold-chain medications.
Examples of common cold-chain medications are insulin for diabetics, eye drops for those with glaucoma and injections to increase red blood cells for kidney disease patients.
At UMMC, for every 100 patients, 15-20 are prescribed with cold-chain medications.
A memorandum of collaboration with Esyms Sdn Bhd was signed early this year to specifically target this issue.
Esyms is a team of pharmacists who know how best to handle medications and the importance of an uninterrupted cold supply chain.
"Esyms has been entrusted to fill the gap between UMMC and its patients who are at home and in need of their medications," says Dr Nazirah.
Essentially, cold-chain involves transportation, storage and handling of temperature-sensitive products every step of the supply chain, from the manufacturer to the end-user to ensure efficacy and integrity of the products, explains Esyms chief executive officer Lam Wee Yong.
It requires a thorough understanding of the characteristic and stability profile of each temperature-sensitive product.
A series of tasks must be performed to prepare, store, transport and monitor them.
INSULATED PACKAGING
Through extensive R&D and preliminary pilot studies over the last two years, the company has devised its own system for the purpose.
It includes specially designed thermal-insulated packing materials, packing methods, a route optimisation tool, automated real-time status updates and trained teams to fulfil delivery, explains Lam.
Temperatures will be monitored, recorded and easily accessed by both the hospital pharmacy and Esyms throughout delivery.
"We implement a high level of control on all the processes in order to meet the specifications necessary to deliver cold-chain medications.
"By leveraging technology, effective communication is made possible not only with the hospital's pharmacy department but also with patients."
The company's Allmeds medication delivery system currently covers hospitals from both the government and private sectors, community pharmacies and GP clinics.
Esyms, therefore, plays a vital role in ensuring continuity of medication for patients, says Lam.
Hospital congestion can also be reduced as patients no longer need to visit the facility just to obtain their medicines.
This, in turn, reduces the workload and burden of hospital pharmacists and enables resources to be directed towards more efficient pharmaceutical care.
During a pandemic like Covid-19, this also directly reduces the risk of the virus spreading among vulnerable groups such as the elderly, who are the main beneficiary of such services.
There are also patients whose caretakers are stuck out of state due to movement restrictions.
This also causes an interruption in their medication routines as they themselves are not able to collect their medicines, especially cold-chain medications, at the hospital.
FOR THE BENEFIT OF PATIENTS
UMMC'S medication delivery service has been a value-added service (VAS) under the Outpatient Pharmacy Unit since 2010.
All the while, only room-temperature medications were delivered, including tablets, capsules, creams, syrups and inhalers.
The reasons for introducing by-post medications were originally to reduce congestion and waiting time at the pharmacy while improving convenience and satisfaction for patients.
The need for by-post medications is even more crucial now during the battle with Covid-19 as it's safer for the public to stay at home.
Medication delivery drastically increased from 150 patients a day to 350 daily during the Movement Control Order periods, with 2020 recording a 150 per cent increase in requests compared to 2019.